Resuscitation
-
Clinical observations suggest that the assumption of a linear relationship between chest compression pressure and cardiac output may be oversimplified. More complex behaviour may occur when the transmural pressure is large, changing the compliances and resistances in the intra-thoracic vasculature. A fundamental understanding of these compression induced phenomena is required for improving CPR. ⋯ Our data strongly indicate that vascular compliance, especially the ability of vessels to collapse (and potentially the cardiac chambers), can be a central factor in the limited output generated by chest compressions. Just pushing 'harder' or 'faster' is not always better, as an 'optimal' force and frequency may exist. Overly forceful compression can limit blood flow by restricting filling or depleting volume in the cardiac chambers and central great vessels.
-
Randomized Controlled Trial Comparative Study
What is the optimal position of an intubator wearing CBRN-PPE when intubating on the floor: a manikin study.
Prompt airway management following a CBRN incident is linked to improved patient survival. However, responding rescuers will have to wear CBRN-PPE and treat patients positioned on the floor which will adversely impact on intubation skill performance. ⋯ This manikin-based study serves to reaffirm that CBRN-PPE has an adverse impact on intubation performance as well as identifying the negative impact of patient position on the performance of intubation within a CBRN environment. Elevating the patient off the floor, prior to intubation, could improve intubation success when wearing CBRN-PPE as well as potentially improving safety of the intubator. In the immediate phase of a CBRN incident, intubation attempts should be delayed until optimal intubating conditions are available or at least until the patient is removed from the floor. Use of and intermediate airway devices should be considered as a 'stop gap'.
-
Comparative Study
Distribution of potassium levels on admission for CPR--severe hypokalaemia with dysmorphophobic eating disorders.
To evaluate the prevalence and cause of severe hypokalaemia in patients administered for cardiopulmonary resuscitation (CPR) for non-traumatic cardiac arrest. ⋯ In contrast to moderately reduced potassium which is a frequent finding in adult patients at the time of admission for non-traumatic cardiac arrest, severe hypokalaemia is uncommon. The high prevalence of patients with body dysmorphophobic eating disorders in this group underscores accidental self-induced hypokalaemia may evolve as an important differential diagnosis in cardiac arrest in young female patients.
-
Comparative Study
Are trained individuals more likely to perform bystander CPR? An observational study.
This study aimed to evaluate the association of cardiopulmonary resuscitation (CPR) training with bystander resuscitation performance and patient outcomes after out-of-hospital cardiac arrest (OHCA). ⋯ People who had experienced CPR training had a greater tendency to perform bystander CPR than people without experience of CPR training. Further studies are needed to prove the effectiveness of CPR training on survival.